provided that everybody follows the
uh the guidance now and everybody sticks
to the
uh to the measures that we have uh now
then
we think that by the middle of february
then you know there really is the
prospect of
um of beginning the relaxation
of some of these measures it seems so
easy just follow the rules
but what we're realizing is it's far
easier for some
than for others if you're living
comfortably working at home
and you have a cough there's every
chance you'll go and get it tested
even just as a precaution but supposing
if you have no job security and cash is
very tight
what are the chances you ignore that
same cough
not everyone is able to work from home
not everyone is able to take time off
work for self-isolation
saving lives restarting the economy also
necessitates
addressing these inequalities and the
given the very the new variant this
might be the difference between a
lockdown bringing r
down below one or not
while headlines were focusing on the
increased transmission potential of the
new
variant coronavirus a public health
england report
was quietly released a week before
christmas
and pointed to other factors that drive
transmission
at the heart of it was inequality
it's highlighted factors including
insecure public-facing jobs without
social distancing
overcrowded housing chronic stress and
pre-existing health conditions
as all contributing to an increased risk
from covert
the country applauded our nhs heroes
last spring
but there are so many other essential
workers keeping the country ticking
through lockdown
in factories and food production for
example they're essential
but are they treated as such really
precarious
essential workers we've not thought
about their position at all
lockdown widens inequality in two ways
it's it widens the difference
in in how likely you are to be at risk
and it like widens the inequality in
whether you're actually ill
in toronto they've looked at infection
levels among essential workers such as
people working in public facing jobs
such as shops deliveries and also
manufacturing and agriculture
the blue line shows those infection
rates amongst the communities with the
fewest essential workers
the orange line covers the middle third
of communities
and the red line shows how infection is
significantly higher
among those communities with the highest
number of these workers
should we just accept that transmission
will always be higher in some
communities than in others
and that lockdown may be increasing that
gap
it's just what's happening is that
they're reducing contact rate more
amongst those folks that were already at
lower risk
and and reducing it less amongst those
folks that were at higher risk and thus
we see those disparities
just worsening and indeed in the sense
of actually
reducing overall transmission they can't
work
in the way that they've been designed
there are over 8 million
essential workers in the uk who simply
cannot work from home
blunt tools such as lockdown with its
associated trade-offs
can only work effectively if it stops
transmission
in the groups transmitting we drove
covid infection rates
right down last summer but what experts
have said is where the embers remained
hottest was in the deprived communities
so what do you do about it i think we
need to think about
support proportionate to the risk of
exposure of an individual
we need to think about additional layer
of support for disadvantaged communities
income relief at the moment only one
third of salary
is recovered when you're off sick and
we need to think about how we can
incentivize sectors
we need to think about whether to
provide accommodation for people living
in overcrowded housing or people don't
who don't have a
house to self-isolate the uk has one of
the lowest proportions of pay covered by
statutory sick pay in europe
and millions don't even qualify i think
when we get into it we
understand that you know the sort of
systematic and structural barriers that
put folks at risk are really at the
heart
of effective interventions rather than
this idea of blaming folks but
but indeed it's natural for us societies
just to blame individuals
i think rather than tackling difficult
and and challenges
issues understandably our politicians
have spent a lot of time trying to make
people
do as they've been told but some are
asking
whether there has been enough effort
thrown at people in those areas
where without help the virus is likely
to thrive
deb cohen with that report we invited
the government on the program they
declined
a spokesman told us they're doing
everything they can to ensure their
coronavirus support reaches those who
need it most
joining me now is rose gallagher the
professional lead for infection
prevention and control
at the royal college of nursing and
dubai a member of the independent sage
formerly acting director of the
runnymede trust
and good evening to you both rose if i
can just start with you to
paint the picture for us if you can of
what you're hearing it's
like currently on your wards so what our
members are telling us
is that the pressure is absolutely
relentless
our nurses and midwives working in all
care settings
and care homes have been working to
support this pandemic now since march
and
working in a pandemic is very much like
running a marathon
you you need pace you need rest um if
you're going to reach the end but our
members are sprinting
and they are absolutely exhausted and
it's a marathon in the sense that we
we we actually don't know how long this
could go on for me nick heard figures
i don't know if you heard that earlier
that the laws will be in place until the
end of march which sounds like the
beginning of april we've been told
mid-february
um i wonder um zubaida
how you managed to get people to follow
a set of rules
when there are such severe economic
consequences uh
for some who are trying to do so
well that's absolutely the key point
emily which is we have been saying
from the very beginning independent sage
have been saying that
in order to get people to adhere to
rules we need to help support them
as you rightly pointed out at the
beginning this isn't just about will
this is about being able to strict to
stick to the
to being able to adhere to the rules and
we know for instance
right from the beginning that black and
ethnic minority people
people in deprived areas were much more
at risk with kobit 19 much more at risk
was of severe illness
and death because of the types of jobs
that they were in because of the types
of accommodation that they live in
because they're much more likely to live
in overcrowded housing and so on
now all of these things matter but what
also matters
in this pandemic is stopping
transmission and the way we
stop transmission is to get people
self-isolated
and we've known from the beginning and
throughout this pandemic
that people in deprived areas that
people in low-paid jobs that black and
ethnic minority people
who are disproportionately in low-paid
jobs and insecure jobs
have been less likely to afford to
self-isolate so let me ask you what
would you actually
say to people in that position would you
say
you have to you have to self-isolate i
know it's really hard
or would you understand that some people
will have to break the rules and will
have to go to work and
obviously will live maybe in
multi-generational families where they
can't make those kinds of decisions
i wonder what message you would give out
they shouldn't have to make that choice
i mean the whole point of the government
is to help us in this pandemic is to
protect us
we know that black and ethnic minority
people we know people in low-paid jobs
we know deprived areas have had to make
difficult choices between going to
unsafe work
and putting food on the table now the
government have been
in the position to help them they've
helped other workers they would say to
be fair they would say they've given
what 280 billion to protect the
livelihoods
of people and 50 million um to help
those on
low incomes so i mean the cash has been
put there for this
it's it's not been enough as as as your
colleague has rightly pointed out that
actually nearly two million people
are not eligible for statutory sickness
pay in this in this country
because they don't earn enough now these
those people are disproportionately and
insecure jobs
are disproportionately in zero hour
contracts and
they're disproportionately women and
this government
haven't done enough they haven't given
enough statutory sickness pay
they've made the eligibility criteria
very high and we know from the liverpool
mass testing dan cardin the mp spoke
about this that in the liverpool mass
testing
pilot only four percent of people in
poorer areas
came forward for the testing because
they were too afraid of getting the
result
and that's because they couldn't afford
to sell isolate
so it matters rose let me turn to you
because lockdown is essentially a
holding pattern for all of us
until we vaccinate everyone from what
you've seen on the front line is the nhs
being used efficiently for that are you
happy with
the the logistical process that's going
on there
well the vaccination programme is a huge
logistical um challenge but the plans
are there of course we
must remember that we've only just
really received the oxford vaccine so
it's early days now
but there is a real commitment um across
the uk to get this to as many people as
possible and gps
nurses in hospitals and other health
care workers
are all part of that we also know that
there are many non-health care workers
that have signed up
and such as volunteers through st john's
ambulance to also
help this effort but i would just also
like to make the point
that if this vaccination program is
going to be successful we do need to
protect the vaccinators as well
so as we have high rates of sickness and
absence in the nhs
and in the independent sector and care
homes what we can't have is our
vaccinators off sick because they are
self-isolating
or have covered themselves okay raised
the point today that you know if we are
throwing everything at this which
understandably
we are then we should probably be doing
this round the clock shouldn't we i mean
this should be a sort of
a military strategy of getting every
volunteer that's offered their name
should be you know called up within 24
hours there are some people that you
hear from who
offer their services and have heard
nothing for three weeks
i wonder if you think it should have
that sense now of
if we're all staying at home for the
most part then then why aren't
then are we throwing everything at it
you know 24 hours a day seven days a
week now
so it's very much being approached like
a military
operation and the military are
supporting and testing
um as you know not everyone would want
to accept an appointment
24 hours a day and some people simply
could not get
to appointments 24 hours a day but
certainly extended hours
of flexibility is absolutely crucial to
its success
zubaida do you think that um the way
we're prioritizing is right at the
moment uh clearly it's the vulnerable
age demographics that are receiving the
jab
first um would you change that order
would you do it in socioeconomic or
ethnic uh demographics to to get
priority access
well emily would you mind first of all
can i just
say one thing which is we're focusing
only on
vaccination and only on lockdown just as
the prime minister has
and independent sage would argue and
have argued consistently
that those must not be the only two
things
those are not the only two things out of
this pandemic what we also need to do is
improve
the contact tracing and the support for
self-isolation now in terms of priority
for vaccination that's a really
difficult question
because we know that that depends on
multiple factors and multiple risk
factors
so the reason over 80 year olds for
instance are being prioritized with a
vaccination
is because age is a significant
predictor
of risk in clovid19 now with ethnic
minorities it's much more difficult
because
there is no one gene for being black
there is no one gene for being asian
and it's not that one gene that the
genetics that is making
black and ethnic minority groups or even
people in deprived groups
you know it's those aren't the
situations those aren't the
characteristics that are making them
vulnerable
so of course it needs much more care
what i would say
is if the government focused on the fine
test tracing isolate and support and
it's the isolation and support the
supported isolation
that matters the most and that is also
going to get us out of this pandemic
because that will suppress the virus and
it will keep the virus down
very much indeed thank you thanks for
joining us